ACTION OF MASSAGE. 193 



diseases friction, which we must now regard as a kind of massage, has 

 been utiHsed since ancient times. It is true that the stroking or rubbing 

 is as often as not in the opposite direction to that of the circulation, and 

 absorption, if occurring, must take place by collateral paths, inasmuch 

 as the diseased spot lies between the material which is thus pressed 

 towards the periphery and the centre of circulation. Furthermore, 

 rubbing differs from stroking, inasmuch as considerable pressure is 

 employed, and new tissue and recently formed vessels may quite possibly 

 be broken down, the further changes then occurring as above noted. 

 The same is true of the system of pressing on and rubbing recent 

 exostoses with a flat piece of wood, which was customary in former 

 times, but the comparative inefficiency of this rudimentary massage 

 lies not so much in the fact of the operator faihng to observe the proper 

 direction as in his altogether neglecting treatment until far too late, 

 until, in fact, the products of inflammation had become completely 

 organised. 



As long ago as 1880 Bayer pointed out in his first publication on 

 massage that in our practice we cannot expect the extensive and 

 successful application of massage which obtains in man. We have 

 already noted that in man the hair is removed and the skin lubricated 

 to prevent pustular eruption. In animals, however, we cannot shave 

 an entire limb, and even if the hair were removed we are able to apply 

 massage in the proper centripetal direction only in a few places, like 

 the neck and back ; at almost all other spots where massage is to be 

 emplo}-ed we are forced to work against the du'ection of the hair, which 

 is very difficult. Bayer attempted to overcome this difficulty by the 

 use of massage rollers consisting of small hollow cyhnders covered with, 

 or entirely constructed of, rubber. Such instruments, however, cannot 

 replace the hand, which so readily adapts itself to the varying contour of 

 the body and allows so much more perfect an estimate to be formed of 

 the pressure employed than can be obtained in any other way. The exact 

 degree of pressure to be used is difficult to judge, and can only be 

 learned by practice and experience. Excess causes injury and delays 

 improvement, as one often sees when the treatment has to be left in lay 

 hands. Bayer prefers to forego massage altogether rather than lea^'e 

 the manipulation to the owner or coachman. The pain caused by 

 pressure and kneading, especially where much force is employed, 

 sometimes renders it necessary to resort to means of restraint. The 

 action of massage is considerably increased by substituting for mere 

 lubricants ointments containing substances which promote absorp- 

 tion. 



x\ctive and gradualh' increasing exercise produces similar results. 



13 



